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Skip to 0 minutes and 12 secondsSARA NAM: Delivering health care and ensuring sexual and reproductive health rights in humanitarian crises is very challenging because of the environment.

Skip to 0 minutes and 26 secondsHumanitarian agencies are often working in unsafe and insecure situations, so they have to be concerned about the safety of their own staff. Makes it difficult for women to access health services and to maintain logistics chains or supply chains to equip health posts. There are often severe constraints to human resources and to finances. And then there's often poor governance or a lack of governance or political will. Infrastructure's often damaged or inadequate. And it's often compounded by the complexities in the political system, which can include where governing bodies can be reluctant to institute sexual and reproductive health. They have competing priorities.

Skip to 1 minute and 18 secondsEnabling sexual and reproductive health rights is also very challenging in situations where there are dominant and negative interpretations of the role of women and women's issues. And those values can often be held onto even more tightly at times of conflict and uncertainty, which make it even harder to operationalise sexual and reproductive health rights. So in humanitarian crises, there's a set of guidelines called the Minimum Initial Service Package, MISP. And this specifies a series of critical actions required to respond to sexual and reproductive health needs at the onset of a humanitarian crisis. So the goal of the MISP is to save lives by implementing these priority emergency interventions for sexual and reproductive health.

Skip to 2 minutes and 10 secondsThe MISP was developed by the Inter-agency Working Group on Reproductive Health in Crises, which was led by the World Health Organisation, UNFPA and UNICEF. This MISP is not just a set of supplies, it's also a set of activities that guide international standards, and should be led and coordinated by trained professionals. So there are five objectives of the MISP. Firstly is to nominate a coordinating agency to lead the interventions and activities related to sexual and reproductive health. Secondly, to prevent sexual violence and manage the consequences of it. Thirdly, to prevent the transmission of HIV. Fourthly, to prevent maternal and newborn mortality and disability. And finally, to work towards implementing more comprehensive sexual and reproductive health care when the situation allows.

Skip to 3 minutes and 12 secondsThere are several standards and guidelines that can support the implementation of sexual and reproductive health rights in humanitarian crises. One of those is the "Inter-agency Field Manual on Reproductive Health and Humanitarian Settings." And that's the result of a collaborative consultative process led by the United Nations, and includes around 100 members from other agencies, including government organisations and non-governmental organisations as well. There are several standards that exist that provide a framework to implementing the MISP, and they're available online. And there are also guidelines that UNFPA have developed, again, with other members from the wider collaboration that address standards for prevention and response to sexual and gender-based violence.

Sexual and reproductive healthcare

Sexual and reproductive health is an often neglected topic in humanitarian crises, but in recent years humanitarian organisations and donors have increased their focus on such healthcare in emergency settings.

In the video, Sara Nam explores the difficulties around implementation, emphasising differences in gender roles and use of the minimum initial service package (MISP), and its five objectives.

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This video is from the free online course:

Health in Humanitarian Crises

London School of Hygiene & Tropical Medicine

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